Claim Requests Report Columns
The following columns are available on the Claim Requests report.
| Column Name | Description | Data Populates From |
|---|---|---|
| Ack Status | Acknowledgment Status | 997 Transaction |
| Attachment Indicator | Attachment Indicator | |
| Billed Amt | Billed Amount | Charge Posting |
| Case # | Case Management Number | |
| Case CSC Prog | Case Management CSC Program | |
| Case Desc | The description of case management | |
| Case Eff Date | The effective date of case management | |
| Case Exp Date | The expiration date of case management | |
| Case Sts | The status of case management | |
| Chg Amt | The charge amount. | Claim Detail tab on the Claim Maintenance window |
| Church | Church | Patient Information |
| Claim Cond | Claim Condition (Abbreviated) | Claim Information |
| Claim Cond Desc | Claim Condition Description | Claim Information |
| Claim Form | Claim Form: 1500, UB, ADA | Insurance Information |
| Claim ID Nbr | Claim ID Number | System Assigned Number |
| Claim Status Category Desc | Claim Status Category Description | 277 or 277u Transaction |
| Claim Status Code Desc | Claim Status Code Description | 277 or 277u Transaction |
| Claim Type | Claim Type | Insurance Information |
| COB | COB Indicator | Encounter Insurance Selection |
| Contracted Ind | Contracted Payer Indicator | Payers Master File |
| CPT4 | The CPT4 code for a charge. | Claim Detail tab on the Claim Maintenance window |
| Created By | Created By | Modification Information |
| Crt Dt | Create Date | Modification Information |
| CSC | Consolidated Services Claim | Displays Y (Yes) for CSC claims in Pending or Archived status Displays N (No) for all other claims, including Candidate Encounter claims in HOLD or Consolidated status |
| CSC TS | CSC Timespan | Displays one of the following for claims in HOLD or Consolidated status: Daily / Weekly / Monthly / Case |
| Ctrl Nbr | Control Number | |
| DiagCodes | The diagnosis codes for a charge. | Claim Detail tab on the Claim Maintenance window |
| Dt of Svc | The start date of service for a charge. | Claim Detail tab on the Claim Maintenance window |
| Encounter | Encounter Number | Encounter Maintenance |
| End Dt of Svc | The end date of service for a charge. | Claim Detail tab on the Claim Maintenance window |
| Ethnicity Category | Ethnicity Category | Ethnicity Category Mapping Master File
|
| Financial Class | Financial Class | Insurance Information |
| Insured Addr | Insured Address | Insured Information |
| Insured CityStZip | Insured City/State/Zip | Insured Information |
| Insured Name | Insured Name | Insured Information |
| Insured Policy # | Insured Policy Number | Insurance Information |
| Media Type | Media Type (Abbreviated) | Insurance Information |
| Media Type Desc | Media Type Description | Insurance Information |
| Mod | The modifiers for a charge. | Claim Detail tab on the Claim Maintenance window |
| Mod Dt | Last Modified Date | Modification Information |
| Modified By | Last Modified By | Modification Information |
| Pat Addr | Patient Address | Patient Information |
| Pat BDate | Patient Birth Date | Patient Information |
| Pat CityStZip | Patient City/State/Zip | Patient Information |
| Pat Day Phone | Patient Day Phone | Patient Information |
| Pat EMail | Patient Email | Patient Information |
| Pat Expired | Expired Indicator | Patient Information |
| Pat Expired Date | Patient Expired Date | Patient Information |
| Pat Home Phone | Patient Home Phone | Patient Information |
| Pat Marital | Patient Marital Status | Patient Information |
| Pat Marital Desc | Patient Marital Status Description | Patient Information |
| Pat Name | Patient Name | Patient Information |
| Pat Smoker | Patient Smoker Indicator | Patient Information |
| Pat Student | Patient Student Status (Abbreviated) | |
| Pat Student Desc | Patient Student Status Description | Patient Information |
| Pat Veteran | Patient Veteran Indicator | Patient Information |
| Payer Name | Payer Name
| Claim Payer |
| Per Nbr | Person Number | Patient Information |
| Prac Name | Practice Name | The practice in which the patient has the recall plan |
| Pref Language | Preferred Language | Patient Information |
| Proc Date | Process Date | Claim Information |
| Race | Race | Patient Information
|
| Race Category | Race Category | Race Category Mapping Master File
|
| Religion | Religion | Patient Information |
| Rendering Phys | Charge Rendering Provider | Charge Posting |
| Rendering Provider | The rendering provider for a charge. | Claim Detail tab on the Claim Maintenance window |
| Req Status | Request Status (Abbreviated) | Claim Information |
| Req Status Desc | Request Status Description | Claim Information |
| Rpt Type | Report Type | |
| RPT Trans Cd | Report Trans Code | |
| Rv Cd | The revenue code for a charge. | Claim Detail tab on the Claim Maintenance window |
| Serv Loc | Service Location | Encounter Maintenance |
| Serv Loc St | Service Location State | Locations Master File |
| Sex Code | Sex at Birth Abbreviation (M/F/U) | Patient Information |
| Sex | Sex at Birth | Patient Information |
| SSN | Social Security Number | Patient Information |